Established in 1998, SINA HealthSystems Foundation is a not-for-profit primary health care (PHC) organization operating 40 facilities across peri-urban and slum communities of Karachi and adjoining areas of Sindh and Balochistan, deliberately situated where access is most constrained. The organization records approximately a million patient visits each year. PHC is more than the provision of healthcare services at the first point of contact, and a functioning PHC organization requires more than a clinic, a doctor and medicines. It requires systems that connect communities with services, equip health workers to deliver care, establish referral pathways, maintain essential infrastructure, and continuously learn…